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Many word processing programs have text editing functionality that allows users to view edits and track changes. It is common for insertions to be underlined and deletions to be struck through. Each program offers tools to show or hide the editing marks, notes about formatting, and embedded comments. How reviewers respond to the editing depends not only on the word processing program but also on the technologies and workflow involved. For example, manuscript editors at JAMA send authors edited manuscripts as PDF files showing text insertions and deletions as well as embedded comments and questions. Authors can respond by using

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